(03) 9331 0951

Acupuncture

Optimising Fertility and Women’s Hormonal Imbalances with Acupuncture – Traditional Chinese Medicine at All Degrees of Health in Essendon

 

Traditional Chinese medicine (TCM) has a very long history of treating gynaecological disorders. Infertility in TCM is described as a failure to conceive after a year or more of regular sexual intercourse with no contraceptive use. Infertility may also be applied to the inability to carry a pregnancy to full term.

As a general rule of thumb, approximately one third of subfertility is due mainly to the female, one third to the male and one third a combination of both male and female factors. Approximately one third of subfertility is ‘unexplained’ which can be very frustrating if you are in that category. TCM can  address some of these ‘unexplained’ factors.

Female conditions affecting fertility include:

  • Endometriosis (where there is endometrial tissue that grows outside of the uterus), causing pain and inflammation during the cycle, especially at period time. This can create localised inflammation, making it harder to conceive.
  • Polycystic ovarian syndrome (or polycystic ovarian disease –PCOS/PCOS). This condition has 4-5 subtypes and a diagnosis is made with 2 out of three diagnostic criteria:
  1. Blood tests including elevated testosterone, free androgens (male hormones) and LH; and evidence of Insulin resistance
  2. Numerous cysts on the ovaries (>15) on ultrasound on either or both ovaries
  3. Symptoms that may include irregular cycles, central obesity (fat around the tummy area), facial hair, acne, difficulty falling pregnant and increased miscarriage rates.
  • Blocked Fallopian tubes – this can occur as a consequence of pelvic inflammatory disease, endometriosis (where the endometrial tissue grows around the fallopian tube), infection or surgery. This is identified via a Tubal patency test upon referral from your doctor. More information: https://womensultrasound.com.au/services/specialist-gynaecological-investigations/#tpa. This test involves putting a dye is put through the tubes and evidence of flow is attained by ultrasound. If you have blocked tubes, assisted reproductive techniques (i.e. IVF) is the only viable approach, as sperm cannot reach the eggs, and no amount of natural intervention will help. Acupuncture and Chinese Herbal medicine can be used as adjunctive treatment to support  IVF treatments.
  • Short ‘Luteal phase” where the second half of the cycle (post-ovulation) is less than 12 days, reflective of insufficient progesterone to support healthy implantation and foetal growth.
  • Fibroids: These are growths in and around the uterus and wall that can hamper implantation and pregnancy success. Fibroids can be reflective of an imbalance in the ratios of the types of oestrogen present causing excessive ‘growth’. The underlying cause needs to be addressed as well as a discussion with your gynaecologist as to whether it is worth removing prior to becoming pregnant.

When working with fertility and preconception clients TCM employs a number of treatment modalities including acupuncture, Chinese herbal medicine, dietary and nutritional therapy, and lifestyle changes.

A Doctor of Traditional Chinese Medicine will usually observe the patient’s tongue, palpate the pulse on both wrists, ask a lot of questions that may seem unrelated to fertility, and may palpate the abdomen or particular acupuncture points on the body for tenderness. This is how a ‘diagnosis’ is made, which is to identify the underlying cause of infertility in TCM. The goal is to help boost overall reproductive energy, and improve and balance hormones to enable a successful and healthy pregnancy.

TCM theory works quite differently to Western Medicine. For example, in TCM the Kidney organ system is responsible for reproduction, growth and aging. When Kidney energy is insufficient or becomes depleted by lifestyle factors such as poor diet, overwork, chronic illness, or simply an individual’s progressing age, subfertility may result. Others causes of infertility in Chinese medicine may involve the ‘Liver’ organ system (often stress related), the ‘Hear’t’ system (often due to emotional blockages), ‘Damp’ obstruction with or without ‘Heat’ (often related to infections or tubal obstructions due to excess fluids or inflammation), Blood stagnation (lack of blood flow to reproductive organs), or Qi and Blood deficiency (lack of vital energy and good quality blood to nourish reproductive organs and promote fertility). All these Patterns of Disharmony in TCM need to be differentiated with all cases infertility so that the best treatment can be prescribed.

In biomedical terms, TCM has a good success rate with unexplained infertility (see references at end of page), which results from hormone imbalances, endocrine gland disorders and emotional problems. Chinese medicine can also significantly improve many structural fertility problems such as pelvic inflammatory disease (PID), endometriosis, uterine fibroids, polycystic ovarian disease (PCOS), ovarian dysfunction and immune related infertility.

Where’s the Evidence:

With over 1300 studies and research papers on acupuncture on the medical research website PubMed, acupuncture and Chinese medicine is one of the most well researched complimentary medicines available. In the prestigious British Medical Journal, a meta-analysis conducted in 2008 which included over 1300 patients showed that acupuncture can improve the success rates of IVF by 60% compared to IVF alone.1. This analysis showed that acupuncture significantly improves fertility in couples trying to conceive. A review conducted in 2007 was the first to show how acupuncture improves fertility based on existing scientific data.  There are four main ways that acupuncture improves fertility:

  1. Acupuncture balances reproductive hormones by restoring balance to the hypothalamus-pituitary-ovarian-adrenal axis.
  2. Acupuncture increases uterine and ovarian blood flow, which significantly improves egg quality and enhances the endometrium (uterus lining). This improves implantation rates of the embryo.
  3. Acupuncture reduces inflammatory cytokines, which have been shown to interrupt conception and reduce fertility.
  4. Acupuncture helps to reduce the effect of stress, anxiety and depression on the body, all of which have been shown to reduce conception rates and increase miscarriage rates.There is also a large body of scientific evidence to support the use of acupuncture in treating male infertility. Although the mechanism of how acupuncture improves male fertility is still unknown, research trials have proven acupuncture’s success in this field. One recent placebo controlled trial showed that acupuncture significantly improved sperm count, motility (how it moves), and morphology (shape and structure) over a five week treatment period in comparison to a placebo acupuncture group. After the tenth acupuncture session, the median percentage of healthy sperm had increased more than four-fold. The researchers reported that acupuncture treatment is a simple, noninvasive method that can improve sperm quality either alone or in conjunction with assisted reproductive techniques such as IVF.Evidence: RESEARCH AND STATISTICSHere’s some current scientific research about acupuncture and natural medicine in regards to male and female fertility:
    • Acupuncture increased the chances of conceiving via IVF by 65%. Acupuncture increased the chance of maintaining a pregnancy beyond 12 weeks by 87%. Acupuncture increased the rate of maintaining a pregnancy to full gestation (live birth) by 91% (1. Manheimer et al, 2008).
    • Acupuncture and Chinese herbal medicine may reduce the risk of miscarriage (2. Nepomnaschy et al, 2006; Sun & Yu, 1999; Takakuwa et al, 1996).
    • Acupuncture and Chinese herbal medicine increase the pregnancy rate of women undergoing Intrauterine Insemination (IUI). 65.5% of women receiving acupuncture and herbs conceived versus 39.4% who received IUI alone, without acupuncture and herbs. (3. Sela et al, 2011).
    • Acupuncture may improve fertility in women trying to conceive naturally or by supporting IVF/IUI via the following mechanisms: Improving uterine and ovarian blood flow, improving the vasculature of the endometrial lining, reducing uterine spasms, reducing stress and anxiety levels, balancing hormones, reducing inflammation and modulating the immune response (4. Anderson et al, 2007).
    • Acupuncture improves semen quality in subfertile men by improving sperm count, motility, and morphology (Chen et al, 2011; Dieterie et al, 2009; Gerfinfkel et al, 2003; Pei et al, 2005). There may also be improvements in sperm count in men with very low sperm counts and idiopathic azoospermia (5. Siterman et al, 2000).
    • Antioxidant supplementation in subfertile men led to a four-fold increase in the clinical pregnancy rate and a up to a six-fold increase in live birth rate compared to placebo, which involved 4179 men. There was a significant increase in sperm count and motility, and a significant reduction in DNA fragmentation (6. Showell et al, 2014).
    • Chinese herbal medicine improves pregnancy rates two-fold in a three to six month period compared to Western medial drug therapy (ie. Clomid) in women diagnosed with female infertility, which involved 4247 women. In addition, fertility factors such as ovulation rates, cervical mucus score, biphasic basal body temperature, and appropriate quality of the endometrial lining were all positively influenced by Chinese herbal medicine therapy (7. Reid, 2015).
    • Chinese herbal medicine improves the ovulation rates of women with irregular or non-ovulatory cycles just as well as the leading drug Clomid in a meta-analysis involving 1316 women (See et al, 2011). Also, Chinese herbs combined with Clomid increases pregnancy rates versus Clomid alone (8. See et al, 2011).
    • Chinese herbal medicine increases ovulation rates in women with PCOS just as well as Clomid (Zhang et al, 2010). Chinese herbs increased the pregnancy rates when combined with Clomid versus Clomid alone. Chinese herbs also seemed to work just as well as ovarian drilling in regards to ovulation rate (9. Zhang et al, 2010).

    References

     

     

1.Manheimer, E., Zhang G., Udoff, L., Haramati, A., Langenberg, P., Berman, B.M., & Bouter, L.M. (2008). Effects of acupuncture on rates of pregnancy and      live birth on women undergoing in vitro fertilisation: systematic review and meta-analysis. British Medical Journal,

  1. Nepomnaschy, P.A., Welch, K.B., McConnell, D.S., Low, B.S., Strassmann, B.I. & England, B.G. (2006). Cortisol levels and very early pregnancy loss in humans. Proceedings of the National Academy of Sciences of the United States of America, 103(10), 3938-3942.
  2. Sela, K., Lehavi, O., Buchan, A., Kedar-Shalem, K., Yavetz, H., & Lev-ari, S. (2011). Acupuncture and Chinese herbal treatment for women undergoing intrauterine insemination. European Journal of Integrative Medicine, 3,(2), 77-81.
  3. Anderson, B.J., Haimovici, F., Ginsburg, E.S., Schust, D.J., & Wayne, P.M. (2007). In vitro fertilisation and acupuncture: clinical efficacy and mechanistic basis. Alternative Therapies in Health and Medicine, 13(3), 38-48.
  4. Siterman, S., Eltes, F., Wolfson, V., Lederman, H. & Bartoov, B. (2000). Does acupuncture affect sperm density in males with very low sperm count? A pilot study. Andrologia, 21(1), 31-39.
  5. Showell, M.G., Brown, J., Yazdani, A., Stankiewicz, M.T., Hart, R.J. (2014). Antioxidant vitamins and minerals for male subfertility. Cochrane Database for Systematic Reviews 2014, Issue 12. Art.No.:CD007411, DOI:10.1002/14651858.CD007411.pub3
  6. Reid, k. (2015). Chinese herbal medicine for female infertility: an updated meta-analysis. Complimentary Therapies and Medicine, 23 (1), 116-28.
  7. See, C.J., McCulloch, M., Smikle, C., et al. (2011). Chinese herbal medicine and clomiphene citrate for anovulation: a meta-analysis of randomized controlled trials. Journal of Alternative and Complementary Medicine, 17, 397-405.
  8. Zhang, J., Li, T., Zhou, L., et al (2010). Chinese herbal medicine for subfertile women with polycystic ovarian syndrome.” Cochrane Database of Systematic Reviews, Art. No.: CD007535. DOI: 10.1002/14651858.CD007535.pub2

Other References and Research: 

Anderson, B.J., Haimovici, F., Ginsburg, E.S., Schust, D.J., & Wayne, P.M. (2007). In vitro fertilisation and acupuncture: clinical efficacy and mechanistic basis. Alternative Therapies in Health and Medicine, 13 (3), 38-48. Systematic Reviews 2014, Issue 12. Art.No.:CD007411, DOI:10.1002/14651858.CD007411.pub3

Reid, k. (2015). Chinese herbal medicine for female infertility: an updated meta-analysis. Complimentary Therapies and Medicine, 23 (1), 116-28.

See, C.J., McCulloch, M., Smikle, C., et al. (2011). Chinese herbal medicine and clomiphene citrate for anovulation: a meta-analysis of randomized controlled trials. Journal of Alternative and Complementary Medicine, 17, 397-405.

Zhang, J., Li, T., Zhou, L., et al (2010). Chinese herbal medicine for subfertile women with polycystic ovarian syndrome.” Cochrane Database of Systematic Reviews, Art. No.: CD007535. DOI: 10.1002/14651858.CD007535.pub2

Male Fertility and Acupuncture:

There is also a large body of scientific evidence to support the use of acupuncture in treating male infertility. Although the mechanism of how acupuncture improves male fertility is still unknown, research trials have proven acupuncture’s success in this field. One recent placebo controlled trial showed that acupuncture significantly improved sperm count, motility (how it moves), and morphology (shape and structure) over a five week treatment period in comparison to a placebo acupuncture group. After the tenth acupuncture session, the median percentage of healthy sperm had increased more than four-fold. The researchers reported that acupuncture treatment is a simple, noninvasive method that can improve sperm quality either alone or in conjunction with assisted reproductive techniques such as IVF.

RESEARCH AND STATISTICS

Here’s some current scientific research about acupuncture and natural medicine in regards to male and female fertility:

  1. Acupuncture increased the chances of conceiving via IVF by 65%. Acupuncture increased the chance of maintaining a pregnancy beyond 12 weeks by 87%. Acupuncture increased the rate of maintaining a pregnancy to full gestation (live birth) by 91% (1. Manheimer et al, 2008).
  2. Acupuncture and Chinese herbal medicine may reduce the risk of miscarriage (2. Nepomnaschy et al, 2006; Sun & Yu, 1999; Takakuwa et al, 1996).
  3. Acupuncture and Chinese herbal medicine increase the pregnancy rate of women undergoing Intrauterine Insemination (IUI). 65.5% of women receiving acupuncture and herbs conceived versus 39.4% who received IUI alone, without acupuncture and herbs. (3. Sela et al, 2011).
  4. Acupuncture may improve fertility in women trying to conceive naturally or by supporting IVF/IUI via the following mechanisms: Improving uterine and ovarian blood flow, improving the vasculature of the endometrial lining, reducing uterine spasms, reducing stress and anxiety levels, balancing hormones, reducing inflammation and modulating the immune response (4. Anderson et al, 2007).
  5. Acupuncture improves semen quality in subfertile men by improving sperm count, motility, and morphology (Chen et al, 2011; Dieterie et al, 2009; Gerfinfkel et al, 2003; Pei et al, 2005). There may also be improvements in sperm count in men with very low sperm counts and idiopathic azoospermia (5. Siterman et al, 2000).
  6. Antioxidant supplementation in subfertile men led to a four-fold increase in the clinical pregnancy rate and a up to a six-fold increase in live birth rate compared to placebo, which involved 4179 men. There was a significant increase in sperm count and motility, and a significant reduction in DNA fragmentation (6. Showell et al, 2014).
  7. Chinese herbal medicine improves pregnancy rates two-fold in a three to six month period compared to Western medial drug therapy (ie. Clomid) in women diagnosed with female infertility, which involved 4247 women. In addition, fertility factors such as ovulation rates, cervical mucus score, biphasic basal body temperature, and appropriate quality of the endometrial lining were all positively influenced by Chinese herbal medicine therapy (7. Reid, 2015).
  8. Chinese herbal medicine improves the ovulation rates of women with irregular or non-ovulatory cycles just as well as the leading drug Clomid in a meta-analysis involving 1316 women (See et al, 2011). Also, Chinese herbs combined with Clomid increases pregnancy rates versus Clomid alone (8. See et al, 2011).
  9. Chinese herbal medicine increases ovulation rates in women with PCOS just as well as Clomid (Zhang et al, 2010). Chinese herbs increased the pregnancy rates when combined with Clomid versus Clomid alone. Chinese herbs also seemed to work just as well as ovarian drilling in regards to ovulation rate (9. Zhang et al, 2010).

 

Other References and Research: 

Anderson, B.J., Haimovici, F., Ginsburg, E.S., Schust, D.J., & Wayne, P.M. (2007). In vitro fertilisation and acupuncture: clinical efficacy and mechanistic basis. Alternative Therapies in Health and Medicine, 13 (3), 38-48.

Pei, J., Strehler, E., Noss, U., et al. (2005). Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility and Sterility, 84(1), 141-7.

Balakier, H. and Stronell, R.D. (1994). Color Doppler assessment of folliculogenesis in in vitro fertilisation patients. Fertility and Sterility, 62(6), 1211-1216.

Bassil, S., Wyns, C., Toussaint-Demylle, D., Nisolle, M., Gordts, S., and Donnez, J. (1997). The relationship betweem ovarian vascularity and the duration of stimulation in in vitro fertilisation. Human Reproduction, 12 (6), 1240-1245.

Chen, A., et al. (2011). Effect of acupuncture-moxibustion therapy on sperm quality in infertility patients with sperm abnormality. Journal of Acupuncture and Tuina Science, 9 (4), 219-222.

Collin, P., Kaukinen, K., Valimaki, M., & Salmi, J. (2002). Endocrinological disorders and celiac disease. Endocrine Reviews, 23, 464-483.

Cridennda D., Magarelli, P., and Cohen, M. (2005). Acupuncture and in vitro fertilisation: does the number of treatment impact reproductive outcomes? Society for Acupuncture Research, 301, 85-88.

Dieterle, S., Li, C., Greb, R., et al. (2009). A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia. Fertility & Sterility, 92, 1340-3.

Gerfinfkel, E., Cedenho, A.P., Yamamura, Y., et al. (2003). Effects of acupuncture and moxa treatment in patients with semen abnormalities. Asian Journal of Andrology. 5,

Gougeon, A. (1996). Regulation of ovarian follicular development in primates: facts and hypotheses. Endocrine Reviews, 17 (2), 121-155.

Grant, L-E., and Cochrane, S. (2014). Acupuncture for the mental and emotional health women undergoing IVF treatment: A comprehensive review. Australian Journal of Acupuncture and Chinese Medicine, 9 (1), 5-12.

Isoyama Manca di Villahermosa, D., Dos Santos, L.G., Nogueira, M.B., Vilarino, F.L., and Barbosa, C.P. (2013). Influence of acupuncture on the outcomes of in vitro fertilisation when embryo transfers have failed: a prospective randomised controlled study. Acupuncture in Medicine, 31 (3), 157-161.

Jackson, J., Rosen, M., McLean, T., Moro, J., Croughan, M., & Cedars, M. (2008). Prevalence of celiac disease in a cohort of women with unexplained infertility. Fertility and Sterility, 89, 1002-1004.

Kasius, A., Smit, J.G., Torrance, H.L., Eijkemans, M.J., et al. (2014). Endometrial thickness and pregnancy rates after IVF: a systematic review and meta analysis. Human Reproduction Update, 20 (4), 530-541.

Kim, J.S., Na, C.S., Hwang, W.J., Lee, B.C., Shin K.H., and Pak, S.C. (2003). Immunohistochemical localization of cyclooxygenase-2 in pregnant rat uterus by SP6 acupuncture. American Journal of Chinese Medicine, 31 (3), 481-488.

Manheimer, E., Zhang, G., Udoff, L., Haramati, A., Langenberg, P., Berman, B.M., & Bouter, L.M. (2008). Effects of acupuncture on rates of pregnancy and live birth on women undergoing in vitro fertilisation: a systematic review and meta-analysis. British Medical Journal336 (7643), 545-9.

Ozturk, O., Bhattacharya, S., Saridogan, E., Jauniaux, E., and Templeton, A. (2004). Role of utero-ovarian vascular impedance: predictor of ongoing pregnancy in an IVF embryo transfer programme. Reproductive Biomedicine Online, 9 (3), 299-305.

Pei, J., Strehler, E., Noss, U., et al. (2005). Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility & Sterility, 84, 141-7.

Rostami, K., Steegers, E., Wong, W., Braat, D., & Steegers-Theunissen, R. (2001). Coeliac disease and reproductive disorders: a neglected association. European Journal of Obstetrics, Gynaecology and Reproductive Biology, 96, 146-149.

Sterner-Victorin, E., Waldenstrom, U., Andersson, S.A., and Wikland, M. (1996). Reduction of blood flow impedance in the uterine arteries of infertile woman with electro-acupuncture. Human Reproduction, 11 (6), 1314-1317.

Sun, F. & Yu, J. (1999). Effect of TCM on plasma beta-endorphin and placental endocrine function in threatened abortion. Zhongguo Zhong Xi Yi Jie He Za Zhi, 19 (2), 87-89.

Takakuwa, K., Yasuda, M., Hataya, I., Sekizuka, N., Tamura, M., Arakawa, M., Higashino, M., Hasegawa, I. & Tanaka, K. (1996). Treatment for patients with recurrent abortion with positive antiphospholipid antibodies using a traditional Chinese herbal medicine. Journal of Medicine, 25 (5), 489-494.